A patient with atrial fibrillation complains of palpitations, shortness of breath, discomfort, chest pain, dizziness, syncope, fatigue.
What do we call atrial fibrillation?
The human heart has four chambers: two atria (right and left) and two ventricles (right and left). In normal conditions, with each heartbeat, the atria contract first, followed by the ventricles. In atrial fibrillation, the atria contract with a completely irregular and often rapid rhythm, with the result that the ventricles follow with irregular contractions. We detect atrial fibrillation on a 12-lead electrocardiogram or one lead lasting at least 30 seconds.
Epidemiological data- Risk factors and complications
Worldwide, 43.6 million people suffered from atrial fibrillation in 2016. It is estimated that one in three adults will experience this arrhythmia at some point in their lives. Atrial fibrillation is the most common cardiac arrhythmia.
Risk factors for the occurrence of arrhythmia are advanced age, male sex, heredity, an acute condition such as an infection or surgery, kidney failure, metabolic diseases such as diabetes mellitus and obesity, alcohol consumption, smoking, sleep apnea syndrome and pulmonary diseases such as chronic bronchitis. Also, the risk factors include cardiovascular diseases, with the main representatives being coronary heart disease, heart failure, cardiomyopathy, peri-myocarditis, hypertension, dyslipidemia, valvular diseases.
Atrial fibrillation can lead to complications such as stroke, heart failure, dementia, depression, reduced quality of life and increased mortality.
Symptoms and types of atrial fibrillation
A patient with atrial fibrillation complains of palpitations, shortness of breath, discomfort, chest pain, dizziness, syncope, fatigue. However, there are also patients who have this arrhythmia but remain asymptomatic.
Atrial fibrillation can be of varying duration
-initial, when recorded for the first time
– paroxysmal, when it returns to a normal rhythm within 48 hours to a week
-persistent, when it lasts longer than a week and an attempt is made to restore the normal rhythm
-permanent, when it is no longer acceptable, and simply an attempt is made to control the pulses and reduce the symptoms.
How is atrial fibrillation diagnosed? What tests are needed?
The doctor can suspect the arrhythmia by palpating the pulse. However, further tests will be needed. These include a clinical examination by taking a good history for known diseases and risk factors, an electrocardiogram to record the arrhythmia, laboratory tests – blood tests and an ultrasound of the heart. In ultrasound, with the help of high-frequency sound waves through a head placed on the chest, the data is presented on a monitor, where the doctor can see how the heart moves. This test helps the doctor identify any underlying structural heart disease.
Additional tests, such as 24-hour heart rate monitor (Holter), chest X-ray, CT or MRI of the heart, CT or MRI of the brain, depending on the findings of the history and basic clinical examination, may be requested.
Treatment of atrial fibrillation
Atrial fibrillation is initially treated with medication. Medications to control the frequency (number of contractions), such as β-blockers, calcium channel blockers, and digoxin, are given. Antiarrhythmic drugs, such as amiodarone, may also be administered to restore normal sinus rhythm. The choice of drugs depends on the pre-existing diseases, the patient’s condition and his desire, as well as the possible side effects. If necessary, drugs from one or both of the categories we mentioned are combined.
Alternatively, atrial fibrillation can be electrically ablated in selected categories of patients using low-energy electrical current. The patient is monitored by a monitor and is under mild sedation, so he is unaware of the use of electricity.
In addition, it is worth mentioning the choice of ablation by specialized electrophysiologists or surgeons, during which an invasive attempt is made to isolate the foci that are usually located near the pulmonary veins and cause the arrhythmia. Ideal patients are patients with paroxysmal or persistent atrial fibrillation with multiple episodes and patients who have failed medication or have side effects.
Because atrial fibrillation is associated with a risk of thromboembolic events, patients should receive anticoagulants. Very low-risk patients are given aspirin, while high-risk patients are given coumarin anticoagulants or newer anticoagulants.
Of course, other co-morbidities such as cardiovascular diseases, pulmonary diseases, diabetes, obesity, kidney disease should also be effectively treated in each patient, and smoking and alcohol should be stopped. The patient will need a cardiologist next to him and an experienced team of doctors from other specialties and nurses for a comprehensive and multifaceted treatment.
Maria Kahrimani
Cardiologist
Creta InterClinic Private Clinic
Member of the HHG Group
63 Minoos, 713 04
HERACLION, Crete
Tel. 2810 373800
Fax: 2810 314900
www.cic.gr, e-mail: [email protected]
Read the News today and get the latest news.
Follow Skai.gr on Google News and be the first to know all the news.
I have worked in the news industry for over 10 years. I have a vast amount of experience in covering health news. I am also an author at News Bulletin 247. I am highly experienced and knowledgeable in this field. I am a hard worker and always deliver quality work. I am a reliable source of information and always provide accurate information.
